Provider Demographics
NPI:1760850721
Name:ANDREW C WESELY MD PLLC
Entity Type:Organization
Organization Name:ANDREW C WESELY MD PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ANDREW
Authorized Official - Middle Name:C
Authorized Official - Last Name:WESELY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:775-771-4749
Mailing Address - Street 1:605 SIERRA ROSE DR
Mailing Address - Street 2:STE 4
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89511-2359
Mailing Address - Country:US
Mailing Address - Phone:775-348-8100
Mailing Address - Fax:775-348-8101
Practice Address - Street 1:605 SIERRA ROSE DR
Practice Address - Street 2:STE 4
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89511-2359
Practice Address - Country:US
Practice Address - Phone:775-348-8100
Practice Address - Fax:775-348-8101
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-09-08
Last Update Date:2015-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV7129207L00000X, 208VP0014X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain MedicineGroup - Multi-Specialty
No207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Multi-Specialty